


I Can Cope With Alive

by TheGameIsOn_Geronimo



Category: Supernatural
Genre: Big Brother Dean, Episode: s07e17 The Born-Again Identity, Gen, Insomnia, Mental Health Issues, slight AU
Language: English
Status: Completed
Published: 2013-09-10
Updated: 2013-09-10
Packaged: 2017-12-26 06:06:53
Rating: Teen And Up Audiences
Warnings: Creator Chose Not To Use Archive Warnings
Chapters: 1
Words: 3,089
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/962500
Author URL: https://archiveofourown.org/users/TheGameIsOn_Geronimo/pseuds/TheGameIsOn_Geronimo
Summary: <blockquote class="userstuff">
              <p>What if Cas hadn't been able to heal Sam? <br/>Dean leaves behind a broken and dying little brother... He isn't sure what he'll come back to find. He only hopes that Alive is on the list.</p>
            </blockquote>





	I Can Cope With Alive

**Author's Note:**

> Slight spoilers for The Born-Again Identity!
> 
> Unbetaed so mistakes are my own and I apologize for them.  
> Please note I have no medical knowledge so I'm really sorry if what happens in this fic would never happen in real life.  
> This is my first Supernatural Fanfic, so I hope you enjoy!

Dean stared at the body on the bed. His brother - although was it really him anymore? The deterioration that had occurred even over the last few days was starkly evident. The skin was too pale, the body too thin - muscle already starting to wear away and malnourishment helping the weight loss along - the eyes sunken, haunted, rimmed by red and dark black shadows.   
Dean had never seen his brother like this - little Sammy, always the one to smile, flashing dimples, or making puppy-dog faces to get what he wanted - not this defeated, tortured soul. He never wanted to see his brother like this again.  
The words Cas had just spoken whirled in his mind.  
Can't do anything.  
I'm sorry.  
Sorry.  
Sorry wouldn't make this better, hell, nothing could. At this rate Sam would die from exhaustion - his whole body shutting down, giving up. Not like the old Sammy at all.  
Sam didn't look at him, or any of them for that matter. Dean, Cas and Meg all wanting to help for different reasons - love, guilt and duty - but without the power or means to achieve their goal. Dean watched Sam, wanting to approach, but knowing that it would panic him - Sam would see Lucifer, not his face after all. He wanted to reach out, to touch, maybe even to pull Sam into one of those rare chick-flick hugs, brushing his fingers through the shaggy hair as comfort for his little brother.  
He turned, unable to bear looking anymore, marching out of the too small, too enclosed, suddenly too hot room, knowing instinctively that Cas and Meg would follow. There was nothing left in there anyway. Maybe just an empty shell of the bravest man Dean had ever known. He supposed the bravery was still shown just by how Sam was holding on - like gripping the edge of a precipice with his fingertips, one slip from falling apart completely.   
He went out into the parking lot, getting into the not-Impala - suddenly wishing so much for the comfort of his Baby being with him. Cas and Meg climbed in after him, and without a word, he drove off, putting the hospital of hell, and inside his broken brother, in the rear-view mirror. It took days for Cas to convince him to go back.  
***  
They expected the worst of course. Dean's hands were shaking on the steering wheel, so once they parked he shoved them into his jacket pockets, fisted tightly. Only Cas accompanied him, Meg having left to do God-knows-what two days before. It had been a week since they'd last been here, and as Dean stepped over the threshold a new wave of pure fear crashed over him. What if Sam was dead? What if he had finally given up? What if he had never had a chance to say a proper goodbye to his brother? What if. What if. What if.  
They approached the front desk, Cas quietly taking the lead when Dean's steps faltered, when he struggled to gain the correct amount of oxygen, because his chest suddenly felt too tight. As Cas asked the receptionist about Sam, Dean clung onto her every word - hearing it strangely muffled under the pounding heartbeat in his ears.   
"Are you family?" She asked, all business and no fuss, unaware that Dean needed to know NOW if a pulse could still be found in his brother’s neck.  
Cas answered simply, "Yes, Dean here is his brother and I am just his friend."  
She nodded, tapping away at her keyboard, "Alright, Room 157, can I advise you to talk to his Doctor before seeing him?"  
"Of course," Cas agreed, "Thank you, ma'am" he finished, turning to Dean - when had he got so good at basic human interaction?  
Dean let out a breath he hadn't realised he'd been holding - a room number meant life. Sam was alive. But, was that really a good thing?  
Dean tried to calm his frenzied heartbeat as he followed Cas to the elevator, pushing the button for Sam's floor. They stepped out into the cool, white hallway and Dean started to march down it in search of Sam's room, before being stopped by Cas tugging on his sleeve and pulling him to a door with the plaque "Dr M. Robinson" on it.   
Cas looked at him questioningly, and Dean merely nodded and shrugged, so he lifted a hand and tapped his knuckles on the door. They waited a second, before a voice from inside called them in.  
They both entered, looking towards the friendly face with the bright smile and twinkling eyes that was sat behind the desk.  
"Hello," he greeted, rising from his chair and approaching them "How can I help you?"  
"Um," Dean swallowed around the lump in his throat, "I'm Dean and this is Cas, we are here to visit Sam Smith - he's my brother, and we were advised to speak with you first."  
"Ah of course, well then have a seat - I have to say I didn't realise Sam had a brother but it will be nice for him to see some familiar faces."  
"How is he?" Dean asked the most important question first.  
"Well," the doctor said, pulling out a file from under the papers on his desk, opening it and flicking through the pages, "He has actually improved."  
Dean and Cas sat up straighter, the first stirrings of hope coming to life inside them, "Improved? How?"  
The Doctor chuckled, "Yes it was very surprising, but a few days ago he managed to sleep and eat more and has generally improved. He still talks to his hallucinations though - in fact, I would say more so. He doesn't seem to be ignoring them, more interacting with them like they are real."  
"But that's bad, right?"  
"Well perhaps not in this context. The hallucinations could have been very desperate to get Sam's attention, therefore stopping him sleeping or eating in many different imaginative ways in Sam's mind. With Sam accepting the hallucinations it may have led to them quieting down, enabling Sam to be healthier. I think at this stage we can't expect the hallucinations to disappear - although we will keep monitoring him, and of course this experience has been traumatising and he will not be like how you once knew him."  
"What does that mean?"  
"Well, his brain has been under stress, this means his behaviour has become more childlike as his brain has broken down under the pressure."  
Dean nodded slowly, not sure what response was suitable. Sam was okay. He maybe wasn't 100% but he was alive and that was the thing that mattered.  
"Can we see him?" Cas spoke up next to him, the blue eyes looking brighter than they had in days after hearing this good news.  
"Of course," Robinson replied, "At this time he'll be in the day lounge. It was lovely to meet you, and I expect we'll see more of each other over the next few weeks." he stood as they did, reaching out to shake their hands and smiling as they exited the office.  
***  
The day lounge was busy with patients, visitors and nurses. Dean easily spotted his gigantor brother hunched over a table in the corner. He had a board game set out in front of him, and yet no other player around him, and his mouth was moving as though he was talking to someone.   
Dean approached, nearly running - unable to get to his pain-in-the-ass little brother quick enough. As he came closer, Sam heard the footsteps, glancing up and the smile Dean had thought he would never see again spreading across his face as he saw Dean. Sam stood and then Dean was hugging him close, because he was real. He was warm and solid and as healthy as he could be. He was alive.   
Sam bent down so he could bury his face into Dean's shoulder - something he used to do as a child, when he had woken from a nightmare, or was scared by the creature in the closet, or when he missed Dad. Dean held him for a few more minutes just letting the feeling of Sam wash over him, before pulling back. Sam looked better than he had a week ago - so much better, almost like a different person. His eyes were brighter and his cheeks fuller, and although he was still too thin, it wasn't as obvious as the gaunt skeleton his brother had been a week previously.   
"I knew you'd come, Dean." Sam whispered quietly, mouth corners turning up slightly, "I was waiting for you." His eyes travelled towards Cas, "And you too, Cas of course. It's good to see you again."  
"It's good to see you on your feet, Sam. I am very sorry for what I did - although I know that that will not change a thing."  
"Thanks, Cas." Sam said in reply, and then he turned and sat back down, eyes scanning the Scrabble board laid out in front of him, "Now you can come and join in the game," he said, voice growing slightly higher and demanding - like a child, Dean thought sadly, but still, that was okay.  
He reached for the chair opposite Sam, but when he saw Sam's eyes widen as he was about to sit there, he stopped, "Sammy?" he questioned.  
"You can't sit there." Sam replied, eyes wide with shock.  
"Why not?"  
"It's taken."  
Dean stared at him. Then looked to the empty chair, then back to his brother, "Is this Lucifer’s chair?" he asked, carefully.  
Sam nodded, using big movements to emphasise his point that: Yes, that was definitely Lucifer’s chair.  
"Ah, okay. Um, sorry." Dean mumbled, moving to the chair next to Sam that was empty.  
"I know, he is just so rude sometimes, isn't he?" Sam muttered, eyes fixing on the area where a head would be if someone was sitting on the chair. He nodded sagely, as something only he could hear replied, "Yes, I really should teach him manners."  
"Sammy?"   
Sam turned, looking at him carefully, "Luci and I think we should teach you manners"  
Dean's eyebrows raised, "Teach me manners?!" he exclaimed.  
"Yes." Sam nodded.  
Dean exchanged a look with Cas, who had been eying Sam sadly through the whole exchange, then turned back to his brother.  
"I’d like to see you try.” He smirked, just go with it his mind repeated over and over, “Go on then, get my letters sorted, I am going to beat your ass at this game."  
***  
They fell into a routine. Dean and Cas would visit every Tuesday, always making sure they could get there no matter what they were doing; always finding Sam in the day lounge with a different board game laid out, ready to play. They would discuss what hunts Dean and Cas had been doing, and what Sam had done in his week.   
Dean would tell detailed stories of fights and research and Sam would watch with huge eyes, like Dean was everything in the World for him in that moment. Then, he would reach out, touch Dean like he was making sure he was still there and real, and then ask in a quiet, timid, but full-of-love voice “Are you Okay?”  
Dean would always smile and nod, causing Sam to grin and look relieved before he would turn back to the Game of the Week, often saying, “It’s your turn.” to Lucifer, or carefully inspecting his cards or the board in front of him.   
Sam would tell elaborate stories about the other patients, or what seemed to be Worlds created by his own imagination. A childish glimmer would enter his eyes and he would tell Dean of things that could never be real, but he seemed to believe were. Lucifer would often come up in these conversations – Sam would either talk about what Lucifer and himself had been doing, like they were suddenly best friends, or he would repeat things he clearly thought Lucifer was saying to them, subconsciously aware that they couldn’t see or hear him.  
Doctor Robinson told them more realistic information - what medication he was on, if any, how he was behaving, acting, how much he was eating. The man quickly became someone they trusted – obvious really, because whenever they left Sam each week they were leaving him in his care. He would tell them about Sam using his puppy-dog eyes to make friends with his fellow patients, how sometimes he wouldn’t speak for hours, content to hide away inside his head, a secret world away from everyone, and he would also tell them about how happy their visits made Sam, how excited he would get every week, sometimes bouncing up and down in joy. These small pieces of information made Dean smile. They made him feel connected to Sam, made him remember the Sam he had been before, even though now his mind was very different.  
The new childishness in Sam was vividly evident some days, with Sam needing help doing the simplest of tasks like eating or getting dressed. He sometimes wouldn’t understand what people were saying, needing it spelled out clearly and slowly, like a toddler learning to speak for the first time. On days like this, Dean would miss the younger brother he had once known, the one with the bitch-face and sarcastic comments and the brilliant, brilliant mind. But, this new Sam reminded him of Sammy when he had been little, and so Dean retook the role of Big Brother and helped Sam in any way possible.  
Occasionally they would see flashes of the old Sam. Sometimes his mannerisms would be similar, the way he pinched the bridge of his nose, or stretched after sitting for a long time. Sometimes he would give out random facts that he’d retained from years of studying and hunting, reminding Dean of all the times Sam had sat by his laptop reeling off facts and information. Once or twice, the Doctor said he had found Sam reading books, fact and fiction. He told them that maybe Sam’s mind was subconsciously trying to maintain the knowledge it contained, trying to heal itself. If anything filled Dean with hope that Sam may one day recover even slightly –this was it.  
***  
It wasn’t always plain sailing though. Sam had days which Dean and Dr. Robinson had quickly labelled as “Bad Days.”  
The Doctor would describe days in which Sam would wake up screaming from terrible nightmares, often curling into himself, crying and refusing to speak again for hours on end. When Dean had found out about these, he had gone to Sam and quietly talked to him, while his brother had hugged his knees to his chest, making his giant frame as small as possible. Sam had opened up to him – described the horror he often went through. The pure agony of Hell, feeling your skin burn in the hot flames, or your skin being ripped off again and again, only for you to suddenly be whole again and the torture to start afresh; the emotional torment of watching people – and Dean learnt very quickly that Cas, Mum, Dad, Bobby, Jess and himself were the most common – get torn to shreds, dying over and over in hundreds of gruesome ways. Dean had hugged him, telling him that “They were fine, he was fine. The dreams were not real. This was. He had escaped from Hell, he was never going to let him go back.”  
Sam could also have arguments with Lucifer sometimes- loud shouting matches across the room at nothing, before falling to the ground clutching his head, covering his ears to keep out the cruel words of his own hallucinations – weak, worthless, freak. Sometimes these could get violent, Sam finding something to use as a weapon and lashing out at anything that came close to him, trying to fight off his own insanity. It was these shows of violence that usually led to Sam being sedated and strapped to his bed until he calmed down.  
When Dean and Cas had first seen one of these breakdowns it had been shocking and painful for both of them – watching Sam fight off imaginary evils and then proceeding to shout his head off at the chair in the corner that no one was sitting on. Dean had been unable to help himself as he’d listened to what Sam was shouting about – “DEAN WILL NEVER LEAVE ME!” he’d cried, tears starting to trickle from his eyes, “HE TRUSTS ME AND BELEIVES IN ME, DON’T EVER SAY HE WILL LEAVE ME ALONE.” He had approached Sam, wrapping his arms tightly around his torso and lowering both of them to the floor. There, he had laid Sam’s head on his lap, carding his fingers through Sam’s long hair and whispering reassurances to him, promises that he would risk his life to keep, and facts that he rarely said – “I love you, Sammy, I’ll never leave you. You mean everything to me.” Then he would hum “Hey, Jude” as Sam calmed down, lulling his baby brother into sleep and then just sitting there, keeping him company and making sure he didn’t float away from them.   
The routine worked well, but when it was broken things became more difficult. If Dean and Cas were ever late, or even missed a meeting – something that only happened once, because Dean couldn’t cope with seeing his brother like that again – Sam would panic and worry. Doctor Robinson told them how he would scream for Dean and Cas, go around looking in every nook and cranny for them, and even tried to escape in order to find them. When Sam didn’t find then, he would run to his room, lock the door and hide under his bed and cry, refusing to come out until someone could give him proof that Cas, and more importantly Dean, were alive, okay and hadn’t given up on him. After that one time, Dean had been called in on the Wednesday to try and help Sam. It had taken four hours to make him come out from his place of refuge.  
But after these moments of fear and madness, Sam would calm down, go back to what now constituted as normal for them, and Dean would smile at him and receive a smile in return and a hug and a wave as they said goodbye for the week. They were fine. Because he could cope with a routine. He could cope with a broken little brother that still loved him. He could cope with alive. They were fine.


End file.
